The long-standing debate is about to be put to rest, which is better for back pain… ice or heat? They both have their benefits and can help to relieve pain, but is one better than the other? Keep reading to find out which is the best for pain relief.
Back pain is very common. As many as 80% of people will experience it at some time in their lifetime. For many, it will be debilitating at first. But, most of the time, home remedies and over-the-counter (OTC) treatments can help ease the pain and get you back to your regular activities.
And these home remedies can be as simple as heat or ice. But which one is more effective? And does it matter which kind of back pain you have? We’ll go through how to decide which one is best for you and when it’s time to put the hot compress and ice aside and see your provider.
Back pain: Cold vs. heat
The short answer: Start with ice when your back hurts after a minor injury. Cold therapy helps most right after you experience pain and up to the first 2 days. Afterward, heat will likely give you more pain relief. Plus, heat will help with stiffness and loosen up your muscles and joints. This will help with your mobility and get you back to your normal activities.
The long answer: The scientific research on ice versus heat for back and muscle pain is inconclusive. In one study looking at muscle soreness (not specific to back pain) after strenuous exercise, cold helped more with pain relief right after exercise and for up to 48 hours. So ice may help if you overdid it or tweaked your back, especially if it was after a workout.
But, over the long term, research gives heat a slight edge. One review study looked at all the available data in regards to heat versus cold for back pain. It found there was some evidence that heat provided a small amount of back pain relief and that ice was not as helpful.
A second review study showed that heat therapy helped somewhat with pain and also helped people move more easily. By improving their ability to move, heat helped people to recover to their normal levels of activity faster.
In all the studies, there was no evidence of significant harm from using heat or cold. So both heat and cold therapy are generally safe.
But let’s take a closer look at when to use ice and when to use heat.
When does ice help back pain?
Ice can help with back pain in the first couple of days right after a minor injury or strain. For example, it can help if you have soreness after a particularly hard workout or if you feel like you tweaked a certain spot or pulled a muscle.
When you apply ice to an area of your body, nearby blood vessels constrict and decrease blood flow to that area. With less blood flowing to those areas, swelling and inflammation also decrease. But this also means that ice comes with some downsides:
- Some studies show that cold treatments can slow down healing over the long term. This can increase the time it takes to recover fully.
- There’s some evidence that cold can make muscles and ligaments less flexible. This can mean a longer time for you to get back to your normal activities
And don’t forget that ice can harm the skin if you leave it on for too long. To prevent any cold injury to the skin, only apply ice for 10 to 15 minutes at a time.
Types of cold therapy
Ice is not the only way to do cold therapy. There are several other ways to apply cold to an injured back:
- Cold towels: Immerse towels in an ice bath, then apply the towel to the skin. This can be more gentle than ice.
- Cold gel packs: You can buy these products in stores, and many people prefer them because they keep things dry.
- Ice packs: You can use a plastic bag filled with ice. Or you can try a bag of frozen vegetables (like peas or corn). Since the frozen pieces are smaller than ice cubes, they can easily mold to the injured area.
- Cold water immersion: For this you sit in cold water at a temperature of 54℉. Athletes may have access to cold pools, but you can do this in a home bathtub. Cold water from pipes underground will be close to this temperature. You may need to add ice cubes to lower the water temperature, especially in summer months.
- Ice massage: In this approach, ice is massaged directly over the injured area of the back. But ice massage is less effective at alleviating pain when compared to cold water immersion.
When does heat help back pain?
Heat can also provide back pain relief in the right circumstances. After the first few days of back pain, heat can help with ongoing pain and stiffness. And usually it takes more than a few days to get back to 100%. Studies show that heat can be especially helpful for muscle soreness 1 to 2 days after a vigorous workout.
Heat helps with pain by increasing blood flow. When you apply heat to a muscle, it relaxes and dilates the blood vessels in that area. This increase in blood flow can help the body repair and heal the injured tissue. The warmth can also improve the elasticity of the area, which can help with flexibility and movement.